1. This report defines the indications, and describes in detail a technique for atlanto-axial arthrodesis. Open reduction, with wire fixation and bone grafting, achieves the objective of immediate stabilisation of an unstable C. 1-2 articulation.

2. The method is illustrated by fifteen consecutive patients who had atlanto-axial arthrodesis. fourteen of whom had excellent results.

3. When the indications are correct, atlanto-axial arthrodesis by the method described is a safe and effective procedure having an excellent success rate.